Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Apr;8(4):705-10.
doi: 10.21037/jtd.2016.01.79.

Outcome of nonsurgical treatment for locally advanced thymic tumors

Chang-Lu Wang  1 , Lan-Ting Gao  1 , Chang-Xing Lv  1 , Lei Zhu  1 , Wen-Tao Fang  1
Affiliations

Outcome of nonsurgical treatment for locally advanced thymic tumors

Chang-Lu Wang et al. J Thorac Dis. 2016 Apr.

Abstract

Background: Surgical resection remains the mainstay of treatment for patients with early-staged thymic tumors, while chemotherapy is most commonly used in stage IV cases. As for locally advanced thymic tumors, especially those unsuitable for surgery, the optimal therapy is still controversial. Thus, we conducted this retrospective study by comparing three nonsurgical treatment modalities to find some clues.

Methods: Three treatment modalities were used in 42 patients from October 2000 to December 2010, including radiotherapy (RT) alone, sequential chemoradiation (SCRT) and concurrent chemoradiation (CCRT). Objective response rate (ORR), overall survival (OS) and toxicity of the three regimens were compared accordingly.

Results: The ORR in all 42 patients was 61.9%, and 5-year OS was 46%. The ORR of RT, SCRT and CCRT were 43.8%, 50% and 87.5%, respectively (RT vs. SCRT, P=0.692; RT vs. CCRT, P=0.009; SCRT vs. CCRT, P=0.051). The 5-year OS of RT, SCRT and CCRT were 30%, 50% and 61.9%, respectively. (RT vs. SCRT, P=0.230; RT vs. CCRT, P=0.011; SCRT vs. CCRT, P=0.282). Eleven patients developed neutropenia of grade 3-4, with 7 in CCRT group and 4 in SCRT, respectively. Nine patients experienced esophagitis of grade 3 with 2 in RT, 3 in SCRT and 4 in CCRT. There were also two cases of grade 3 radiation induced pneumonitis in CCRT group. No life-threatening side effects were noted.

Conclusions: When used to treat locally advanced thymic tumors unsuitable for surgery, CCRT performed more favorably than RT alone or SCRT in both tumor response and long time survival, but probably with the increasing risk of pulmonary damage. CCRT may offer the best chance of disease control in the management of locally advanced disease.

Keywords: Thymic tumor; chemotherapy; radiotherapy (RT).

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Overall survival (OS) of all 42 patients.
Figure 2
Figure 2
Survival curves of three treatment regimens (CCRT vs. SCRT, P=0.282; CCRT vs. RT, P=0.011; SCRT vs. RT, P=0.230). CCRT, concurrent chemoradiation; SCRT, sequential chemoradiation; RT, radiotherapy.
Figure 3
Figure 3
Overall survival (OS) of patients with Masaoka III and IV tumors (P=0.009).
Figure 4
Figure 4
Overall survival (OS) of patients with thymoma and thymic carcinoma (P=0.163).
See this image and copyright information in PMC

Comment in

References

    1. Engels EA. Epidemiology of thymoma and associated malignancies. J Thorac Oncol 2010;5:S260-5. 10.1097/JTO.0b013e3181f1f62d - DOI - PMC - PubMed
    1. Kondo K, Monden Y. Therapy for thymic epithelial tumors: a clinical study of 1,320 patients from Japan. Ann Thorac Surg 2003;76:878-84; discussion 884-5. 10.1016/S0003-4975(03)00555-1 - DOI - PubMed
    1. Riely GJ, Huang J. Induction therapy for locally advanced thymoma. J Thorac Oncol 2010;5:S323-6. 10.1097/JTO.0b013e3181f20e90 - DOI - PubMed
    1. Benveniste MF, Korst RJ, Rajan A, et al. A practical guide from the International Thymic Malignancy Interest Group (ITMIG) regarding the radiographic assessment of treatment response of thymic epithelial tumors using modified RECIST criteria. J Thorac Oncol 2014;9:S119-24. 10.1097/JTO.0000000000000296 - DOI - PubMed
    1. Fang W, Chen W, Chen G, et al. Surgical management of thymic epithelial tumors: a retrospective review of 204 cases. Ann Thorac Surg 2005;80:2002-7. 10.1016/j.athoracsur.2005.05.058 - DOI - PubMed